Patient side mesh
The surgeon indicates in advance the type and size of the implant (light polypropylene of the required size with an overlap margin of 3–4 cm in all directions); The technique is standard - the mesh is placed under the aponeurosis (sublay) with fixation, the defect above it is sutured. The final cost consists of the price of the operation according to the price list and the receipt for the implant - sometimes this is more profitable, and the quality of the plastic surgery is no different from the all-inclusive option. The sutures are removed on the 8-10th day, the bandage is removed for 4-6 weeks.
Indications
- umbilical hernia in adults - planned treatment;
- pain, episodes of irreducibility - risk of strangulation;
- small defects up to 1.5–2 cm - plastic surgery without mesh is possible;
- defects larger than 1.5-2 cm and relapses - plastic surgery with a mesh implant.
Choice of plastic surgery
For small defects in young patients with a strong aponeurosis, plastic surgery using one’s own tissues (according to Mayo/Sapezhko) is acceptable - without an implant, but with a longer limitation of loads; for a defect of 1.5–2 cm, tissue weakness, obesity and relapses, the mesh is the standard: it covers the ring with a margin and reduces relapses from 15–30% to 2–5%. Open access through a small incision is optimal for a typical umbilical hernia; The laparoscopic option is considered in combination with diastasis and other defects (see the laparoscopic plastics page in the same group “Options and prices”).
